I don't know about you gents, but something that seriously bothers me is that every time it's brought up that men commit suicide at four times the rate that women do, people often retort "but women attempt more!"

Now, philosophical issues with comparing the non-refundable dead with those that attempted and survived aside, this is a claim that is often made but almost never cited.

Here's a link which comes up if you try to look into attempt rates, but there's some problems with it. First, this particular study only looked into post-attempt hospitalization, which means that any attempt that didn't result in being admitted to a hospital is not included. Second, the sample size is only 147 people. Third, the gender parity of the study has over three times as many women as men.

The most important conceit, however, is in the Background section where this study states:

Literature data suggest that suicide attempts are more frequently undertaken by women, whereas men are more often the performers of effective (lethal, fatal) suicides

This study, like the first, only takes into consideration hospitalizations. But it does actually have some data points and a larger data set. This line sticks out:

In 1998/99, the age-standardized hospitalization rate for attempted suicide was 108 per 100,000 females aged 10 or older and 70 per 100,000 of their male counterparts. Some research has indicated that women are more likely than men to make suicide attempts that are actually intended to be non-fatal, but this view remains controversial.

Well that's a funny thing to throw out there but not expand upon. Let's dig into the sources behind that snippet.

Man, this article has a bunch of interesting information. Particularly the following excerpts:

Is the female predominance among those with nonfatal suicidal ideation or behavior real or an artifact? Is nonfatal suicidal behavior underreported in men? According to Whitehead, Johnson, and Ferrence (1973), high rates of nonfatal suicidal behavior in females, as compared to males, may be an artifact of biased data collection, specifically, the exclusion of data on nonfatal suicidal behaviors from male-dominated institutions such as jails. In Alberta, Canada, for example, Bland, Newman, Dyck, and Orn (1990) found that 91% of 15,336 persons sentenced to correctional centers were males. Their study revealed that in correctional settings males have high rates of nonfatal suicidality. In jails and prisons in the Netherlands, 96% of those who engaged in nonfatal suicidal behavior (and 100% of suicides) were males, presumably reflecting a similar gender distribution in the base sample (Kerkhof & Bernasco, 1990).

The medical seriousness of a suicidal act might not, however, correlate with suicidal intent. Again using the Canadian data set (Sakinofsky et al., 1990), we calculated suicidal intent scores based on the circumstances of the act, using the Suicidal Intent Scale (SIS) (Beck, Beck, & Kovacs, 1975; Beck, Morris, & Beck, 1974; Beck, Schuyler, & Herman, 1974). The mean score for females was 2.88 (SD = 2.30), and for males, 3.07 (SD = 2.29) (n = 227, t = .61, p = .55). In other words, females and males appeared to be equally intent on killing themselves. Finally, we measured suicidal intent at the time of the index suicidal act, using an ordinal scale derived from early work by Shneidman (1966) and Kessel (1966). When graded according to whether the act was intentionally suicidal (cessation intended or subintended – the person wanted to die or did not care whether or not he or she lived), 18.4% of females” and 27.7% of males’ suicidal acts fell into this category.

In sum, in Western countries, the high number of females among those who are suicidal, as compared to males, may be a less consistent phenomenon than previously thought. We have documented examples of localities (e.g., Helsinki, Finland) and ethnic minorities (e.g., Native Hawaiians in the United States) where one finds an exception to the expected pattern. Finally, we have reviewed evidence concerning the gender-related meaning of nonfatal suicidal behavior in the United States (i.e., the association of nonfatal suicidal behavior and femininity) and suggested that these beliefs may lead to underreporting by and about suicidal males. We have also speculated on the role of these beliefs in creating a gender gap in rates of nonfatal suicidal behavior.

There are no national, population-based data on attempted suicide. Weissman (43) reviewed English-language studies on attempted suicides between 1960 and 197 1, nearly all of which reported on data from hospital admissions.

Lifetime data from the few community studies that have been conducted demonstrate findings similar to those based on hospital data (44-46). Schwab and colleagues (44) found lifetime attempt rates to be 4.0% for women and 1.2% for men; other studies (45,46) did not report separate estimates of attempts by gender, but did note that risk was higher in women.

Lifetime data are subject to recall bias, since they are heavily dependent on a person’s ability to remember important events. Since women are generally considered to be better reporters of health history than are men, as well as more frequent users of health services, the higher lifetime rates of attempted suicide among women may not represent patterns of recently attempted suicide in the population.

Later analyses of the ECA data addressed this potential bias by examining l-year prevalence of attempted suicide. The prevalence of recent attempted suicide in the year prior to baseline was 22/100,000. The prevalence was 19/100,000 in the year prior to follow-up (55). There were no significant gender or age differences for either prevalence period.

Two studies of suicidal behaviors in community populations of adolescents also failed to find gender differences for medically lethal attempts (4 1, 42). Garrison and associates (42) analyzed data from the Youth Risk Behavior Survey in South Carolina. They found that high school females reported significantly more suicide behaviors of all kinds in the past 12 months than did males, regardless of race. However, although the proportion of attempts requiring medical treatment was slightly higher among females (white females = 1.9%, black females = 2.3%, white males = 1.2%, black males = 0.8%), there were no statistically significant differences between race and gender groups (42).

Summary:

After several hours of research, I could not find any conclusive evidence that women attempt suicide more than men. There's definitely several indications that women self-report suicidal thoughts and are hospitalized for self-harm more frequently than men, but there are also several indications that men self-harm with the intent to die more frequently.

At best, it seems the claim that "women attempt more" is inconclusive as studies have primarily focused on hospitalization rates, self reporting lifetime surveys, and including no-lethal-intent self-harm in with lethal-intent self-harm. At worst, the claim appears to be yet another statistical distortion to elevate women's health issues and minimize men's health issues.

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